Provider Demographics
NPI:1184922874
Name:NWIZUGBO, PRISCA (ARNP, PMHNP)
Entity type:Individual
Prefix:MISS
First Name:PRISCA
Middle Name:
Last Name:NWIZUGBO
Suffix:
Gender:
Credentials:ARNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 S GRADY WAY STE 249
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3209
Mailing Address - Country:US
Mailing Address - Phone:425-233-0431
Mailing Address - Fax:425-329-8087
Practice Address - Street 1:15 S GRADY WAY STE 249
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-3209
Practice Address - Country:US
Practice Address - Phone:425-233-0431
Practice Address - Fax:425-329-8087
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-04
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60196567363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health